Qassim Mohammed Salman, a 46-year-old resident of Nasiriyah province in southern Iraq, has grappled for years with the devastating effects of cancer in his family.
“We have endured immense suffering all these years,” Mr Salman told The National. “It is a real struggle both emotionally and financially – the entire family is under tremendous strain and in a bad mood.”
Mr Salman stands at the forefront of a growing crisis sweeping Iraq: a surge in cancer cases coupled with insufficient treatment facilities and occasional lack of medicines.
Officials blame several factors for the spread of cancer, including environmental pollution and unhealthy habits.
According to the latest annual report on cancer cases in Iraq, a staggering 35,815 new cases were registered nationwide in 2021, up from 31,692 cases reported the previous year.
The incidence rate was reported at 86.9 per 100,000 people, more than double the rate recorded in 1994, which stood at 38.91 per 100,000.
Breast cancer was the highest reported form of the disease for both men and women, followed by bronchus and lung, colorectal, brain and other central nervous system, and urinary bladder cancers.
The real number of cancer cases could be higher as the data does not include people seeking treatment outside Iraq, the general director of the Iraqi Cancer Board, Tahseen Al Rubai, told The National.
“Our population is increasing by nearly one million a year, so we consider the number of the cases within the expected range,” Dr Al Rubai said.
He attributes the increase in cancer cases to rapidly changing lifestyles and pollution.
“We all follow wrong habits in our life,” he said. “Our life has changed to a new one that depends on mobile phones, lack of exercise, unhealthy food, smoking and the rampant pollution in the country.”
He also emphasised the lack of public awareness about cancer prevention and the challenges of late diagnosis.
“So, we are talking about a social problem. We need to build an educational environment to promote a proper community health culture,” he said.
Mr Salman's heart-rending tale is only one of many, with families across the country grappling with the fallout from the disease, sacrificing not only their emotional well-being but also their financial stability and hopes for the future.
The dire situation of Mr Salman's family mirrors the larger issue of insufficient healthcare infrastructure in Iraq, particularly in remote regions.
The burden of travelling long distances, coupled with the exorbitant cost of treatment, places an immense strain on already vulnerable families.
Mr Salman's father has been sick for nearly a decade, with the disease has now spread throughout his body, necessitating extensive chemotherapy and radiology treatments.
Already burdened by the high cost of treatments and extensive travel expenses, Mr Salman has resorted to selling off his family's assets.
He has liquidated two plots of land, a clothing shop and even his wife's sewing machine, scraping together the needed funds to cover the mounting expenses. The family now survives on government unemployment payments and charitable donations.
The chemical and radiology therapy are only available free of charge at government hospitals, which also offer subsidised medicines – but sometimes there are shortages. Other needs can only be fulfilled by the private sector.
“I have sold everything I can to save my father's life, but it is never enough,” Mr Salman said, his voice filled with desperation.
The absence of medical centres and specialised doctors in his hometown has forced him to embark on arduous journeys to neighbouring provinces such as Mayssan, Baghdad, Basra and Najaf to seek medical attention for his father.
They were happy when a radiation therapy machine was installed in the city, but their hopes were dashed when the Indian experts were unable to secure residency in Iraq and they had to leave.
Since mid-June, he has been waiting for an appointment at a hospital in Mayssan province, but the two machines, operated by Egyptian experts, are currently broken.
Shortage of specialised staff
Dr Al Rubai acknowledges that lack of funding and the instability that followed the 2003 US-led invasion that toppled Saddam Hussein have been among the impediments in Iraq’s fight against the cancer.
In a positive development, Iraq for the first time has allocated a special budget of 200 billion Iraqi dinars ($151.5 million) in this year budget for tumour treatment, in addition to more funds from the Health Ministry budget.
Plans are under way to construct at least five medical centres across the country equipped with modern radiation machines, he said.
However, there is also a significant shortage of physicians specialised in cancer medicine – only nine nationwide – as well as shortage of technicians and medical aids trained to operate radiation machines. Currently, Iraq relies on foreign experts, mainly from Egypt and India, to bridge this gap.
Life-saving treatment abroad
In May 2019, Maysara Mohammed Khalid was diagnosed with bone cancer and since then she has embarked upon an arduous journey to seek life-saving treatment abroad.
“I was only 17 years old when I was diagnosed with cancer. Then, I had no idea about the chemotherapy and how it is taken,” Ms Khalid told The National.
“When I got the first dose in Iraq, they put me with elderly of up to 80 years old. It was a big shock to me.
“Ten days later, I started losing my hair and with it I started to realise and accept the new situation.”
After her first dose, she was advised to seek further medical attention in India due to the complexity of her case. The advanced treatment, which focused on the bones directly rather than the whole body, was not available in Iraq.
There, she underwent an intensive year-long treatment that included 18 chemotherapy doses and a groundbreaking surgery to replace her joint and thigh bone.
“In Iraq, they told me that amputation was the only option,” she recalled.
Despite successfully battling the cancer and returning to Iraq in late 2020, her fight was not over. In early 2023, during a routine medical check-up, the cancer resurfaced in her lungs, now at a very advanced stage four.
“The check was not precise. In Iraq, they found only one tumour, but in India they discovered three and two of which needed immediate removal,” she said.
Her case shows the disparity in medical care between Iraq and other countries.
“My treatment was not available in Iraq, and even if it is available, I can’t get the needed medical care,” she said, explaining that her treatment in India required her to stay in the hospital for four days for each dose, which was not possible in Iraq.
The financial burden of seeking treatment abroad was substantial. She relied on donations to fund her medical expenses during her initial trip to India.
To fund her ongoing treatments, she started her own business importing hair oil from India. Every three months, she can earn $1,500 of the roughly $3,500 she needs for each trip.
Reflecting on her battle with cancer, she said that the experience has transformed her life for the better. She found strength in herself and learnt valuable life lessons.
“For me, this disease is a good thing from God,” she said at Baghdad International Airport on her way to India.
“It has changed a lot of things in my life for better, it has made me stronger, I have learnt a lot and I have a lot of friends now.”